Efficacy and safety of Intacs SK in moderate to severe keratoconus

To examine the safety and efficacy of Intacs SK for moderate to severe keratoconus (KC) using femtosecond technology.

This prospective, non-comparative study included 37 contact lens intolerant keratoconic eyes (stage II-III) of 24 patients who underwent femtosecond-assisted Intacs SK implantation. Inclusion criteria were mean K readings <56.00 D, corneal thickness >400 μm at the incision site, mesopic pupil <6.50 mm. Evaluation included manifest refraction, slitlamp examination, corneal topography, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA). P < 0.05 was statistically significant.

Thirty-one (83.8%) eyes were classified as Amsler-Krumeich's stage II and 6 (16.2%) were stage III. Mean central pachymetry was 490.3 ± 37.4 μm. UDVA at 6 months post-operatively was significantly better than pre-operatively (0.90 log MAR ± 0.52 standard deviation [SD] versus 0.32 ± 0.27 logMAR; respectively, P < 0.0001), as was the spherical equivalent (SEq) (-3.64 ± 2.52 D vs. -1.84 ± 2.2 D; P < 0.0001). The mean CDVA and manifest cylinder improved compared with pre-operatively (P = 0.319 and P = 0.078, respectively). Average keratometry decreased significantly from 48.50 ± 3.08 D to 44.40 ± 3.03 D (P < 0.0001).

Implantation of Intacs SK using femtosecond laser in moderate to severe KC is safe and effective.